Provider Demographics
NPI:1184700072
Name:THEIN, ALAN WALAR (RPH)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:WALAR
Last Name:THEIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 AVALON WAY
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9579
Mailing Address - Country:US
Mailing Address - Phone:541-298-5680
Mailing Address - Fax:
Practice Address - Street 1:1400 W 6TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3520
Practice Address - Country:US
Practice Address - Phone:541-298-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0009562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist